NPI | 1467165795 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16634) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-01-02 |
Last Update Date | 2023-03-09 |